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Volunteer Online Application
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2025-01-10T13:57:29-07:00
Volunteer Application
Online volunteer application to be reviewed by the Volunteer Coordinator.
Name (first and last)
(Required)
Street Address
(Required)
City
(Required)
Zip Code
(Required)
Closest major intersection at your subdivision (if available)
Home Phone Number
(Required)
Cell Phone Number
Email Address
(Required)
Date of Birth
(Required)
Gender
Mailing Address (if different from home address)
Emergency Contact
(Required)
Relationship
(Required)
Emergency Contact Phone Number
(Required)
Allergies
Do you smoke?
(Required)
No
Yes
Languages Spoke (other than English)
Local Faith Community, if applicable.
Interested in:
(Required)
Shopping for
Transportation
Personal Paperwork
Shopping with
Home Safety Visits
Personal Checking/Account
Shopping pick up
Grant Writing
Reconciliation, Reading Mail
Caregiver Relief
Special Events
Help with Medical Forms
Friendly Phoning
Pet to Vet
Office Call Center
Friendly Visiting
Board of Directors
Office Assistant filing, copying, etc..
Mailings
Household Repairs (minor only)
Carpentry
Heating/Cooling
Change filters
Grab bars
Electrical
Plumbing
Other
Present Availability (Check all the days and times you may be available to help
(Required)
Monday AM
Monday PM
Tuesday AM
Tuesday PM
Wednesday AM
Wednesday PM
Thursday AM
Thursday PM
Friday AM
Friday PM
Assignment Type (Check your preferences)
(Required)
On-call (different Neighbors, one appointment at a time)
Ongoing (same Neighbor; once a week, every other week or monthly)
Substitute (for a regular assignment, for a limited time)
Times of the year that you know you will be unavailable
Would it be okay for us to call you to see if you could help more than once during the week, e.g. provide transportation in addition to your regular assignment?
(Required)
Yes
No
Vehicle Type: (We will need copies of proof of auto insurance and driver's license)
(Required)
Sedan
SUV
Truck
Van
Driver's License No.
(Required)
Expiration Date
(Required)
State
(Required)
Would you be willing to help with transportation between?
(Required)
Prescott and Prescott Valley
Prescott and Chino Valley
Chino Valley and Prescott Valley
Reference - Co-worker, supervisor (business or volunteer, past or present)
Phone Number
Relationship to Volunteer
Reference - Personal (excluding family) or Professional
Phone Number
Relationship to Volunteer
How did you hear about People Who Care?
(Required)
Hobbies, Interests, Occupation or Former Occupation
In submitting my application to volunteer for People Who Care...
(Required)
Yes
I acknowledge that I have attended a volunteer orientation; received the Volunteer Handbook, and will abide by the policies presented.,I understand that People Who Care requires and Arizona Law stipulates that drivers have a valid driver’s license and the minimum auto insurance required by the state. ,Volunteers will not assume responsibility for, nor enter into, any written or verbal contractual agreements with their People Who Care Neighbor. Examples include, but are not limited to, power of attorney, guardian, conservator, joint bank accounts, check signing, promissory notes, borrowing or lending money, life insurance policies or deeds.,I understand and agree that I will keep all information regarding the Neighbors (clients) private and confidential. However, I do understand that I will convey to the People Who Care staff any information about a Neighbor that may concern their health and well-being.,As a representative of People Who Care, I will have my photo badge with me when providing direct service and return the badge to the office when “retiring” from volunteering with People Who Care.,I understand that People Who Care will contact the references I have provided and will check my driving record. ,People Who Care reserves the right to refuse any volunteer it determines to be inappropriate to assist our vulnerable population.
Have you ever been convicted of a criminal offense, or do you have charges pending for a crime?
(Required)
Yes
No
Applicant's Signature
(Required)
Date
(Required)
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